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How Do Workers’ Compensation Claims Work?

Posted on in Work Place Injuries

Countless individuals go to work each day, never expecting anything to go wrong. However, in Texas, there are many industries where workplaces are filled with potential dangers, and companies are expected to protect their workers from injury and keep them safe.

Still, workers can suffer significant injuries while working. This leaves them with a few different options to pursue compensation and the benefits they need. One of the most common claims they can file is workers' compensation, which can be very useful as long as the process is navigated carefully.

Filing a Workers' Compensation Claim

Before you move forward, you should know that Texas does not require all employers to carry workers' compensation coverage for their employees. In cases where the employer does not carry workers' compensation coverage for their employees or those involving an intentional act that results in serious injuries, the worker may have the right to file a lawsuit against the employer or other party responsible for damages.

However, if your employer does offer workers' compensation coverage, filing a claim requires you to have specific information regarding how the accident occurred, what type of injury you sustained, how long you may be out of work, and whether your position qualifies for coverage.

You may be eligible for certain benefits that you would normally receive had you not suffered an on-the-job injury or condition. It's imperative to know, though, that workers' compensation claims can be denied, making it critical to your case to have legal representation.

Also, even if an injured worker can't sue his or her employer because the employer has worker's compensation, if the injury was caused by somebody outside the employer or by a defective product, the injured worker can still bring a lawsuit against those responsible.

What Is Workers' Compensation?

When an employer does have workers' compensation, it serves as an insurance coverage that is available in lieu of a lawsuit. When you file a workers' compensation claim, you're agreeing to forego any legal action in order to recover your benefits.

Because you must file necessary paperwork and do so in a timely manner, you should hire a legal professional who can help you navigate the process. With legal help, you can increase the chances of having your claim approved the first try.

What Happens If a Claim Is Denied?

If your claim is denied, there may be options for you to appeal the denial and continue your pursuit of compensation through various legal methods. Certain workers' compensation providers will deny claims for the following reasons:

  • You did not file a report with your supervisor immediately following the accident and subsequent injury
  • You went to a doctor who was not approved by the insurance company to diagnose the injury
  • You didn't file the claim in a timely manner and the ability to do so has run out
  • You are deemed able to work still and you are not eligible for benefits

In many cases, people who are denied simply accept that decision as final. When you do this, you're giving up your opportunity to get the benefits you rightfully have earned through your commitment to your company and your time working.

If you've been wrongfully denied a workers' compensation claim, you can reach out to our team at The Edwards Law Firm to discuss your legal options moving forward. We're ready to help you understand why the claim was denied, and help you put together a strong case strategy to proceed in the most favorable manner possible.

With our Corpus Christi workers' compensation attorneys on your side, you can have peace of mind knowing that dedicated legal professionals are working to protect your rights and best interests. Let us be the voice you need to receive the benefits you deserve.

Call our firm today at 361-698-7600 and speak with a member of our team about your options moving forward. We're here to help you through it all.

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